Using a computer to improve functional writing in a patient with severe dysgraphia

This case study describes and evaluates the therapy administered to MF to improve his severe writing impairment caused by a stroke eighteen months prior to this therapy intervention. Therapy was based on developing a compensatory strategy using his residual skills of being able to spell a word orally. A detailed account of the sequence of therapy procedures is given, initially focusing on specific non-functional tasks, followed by therapy with a more functional focus. A computer was used throughout the intervention to facilitate intensive repetitive practice. The intervention proved to be successful, both in terms of improvements on assessments and with evidence of functional benefits. The use of both a dictionary to support the strategy and an adaptive word processor to promote functional carryover is described. The role of the computer in therapy is discussed as a tool to facilitate repetitive practice of therapy and encourage the independent use of the strategy embodied in therapy.